Alcoholism

June 4, 2011

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Alcoholism   - A disease that occurs when the systematic abuse of alcohol is characterized by psychic dependence in intoxication, medical and neurological disorders, the degradation of the individual. The disease can progress and abstinence from alcohol.

In the CIS, 14% of adults abuse alcohol and 80% drink alcohol moderately, driven by some drinking traditions, formed in society.

Often lead to abuse of factors such as conflicts with family, unsatisfactory level of life, inability to realize themselves in life. At a young age the alcohol is used as a way to experience the interior comfort, courage, overcome shyness. The average age is used as a way to relieve fatigue, stress, get away from social problems.

The constant recourse to this method of relaxation leads to permanent dependence and the inability to feel an internal comfort without alcohol. According to the dependence symptoms, and there are several stages of alcoholism.

Stages of alcoholism

The first stage of alcoholism.   For the first stage of the disease is characterized by increase of dose and frequency of alcohol intake. There is a syndrome of altered reactivity in which the alcohol tolerance varies. Disappear protective reaction of the body of an overdose, particularly when there is no vomiting, the use of high doses of alcohol. With strong intoxication observed palimpsests   - Memory lapses. Psychological dependence is manifested dissatisfaction in a sober state, constant thoughts about alcohol, raising the mood before taking alcohol. The first stage lasts from 1 to 5 years, with the desire to control, because there is no physical dependence syndrome. Man does not degrade or lose the ability to work.

Complications of alcoholism first stage is primarily manifested by the liver occurs Alcoholic fatty degeneration . Clinically, it almost does not appear in some cases there may be a feeling of fullness, flatulence . diarrhea . You can diagnose a complication and to increase consistency plotnovata liver. On palpation of the liver edge is rounded, it is more sensitive. With abstinence, these symptoms disappear.

Complications from the pancreas is sharp   and   Chronic pancreatitis . This marked abdominal pain that radiates to the left and are located in the back, as well as loss of appetite, nausea, bloating, unstable chair. Often, alcohol abuse carries to alcoholic gastritis, in which also no appetite and nausea, pain in the epigastric region.

The second stage.   Alcoholism is the second stage of the progression period from 5 to 15 years and is characterized by increased reactivity of the modified syndrome. Alcohol tolerance reaches a maximum, there are so-called psevdozapoi Their frequency is not associated with the patient's attempts to get rid of addiction to alcohol, and to external circumstances, such as lack of money and the inability to get alcohol.

In place of the sedative effect of alcohol comes activating, memory lapses when consuming large amounts of alcohol are replaced by full amnesia   end intoxication. This daily drinking due to the presence of psychic dependence syndrome, sober patient loses the ability to mental work, there is a disruption of mental activity. There is a physical syndrome of alcohol dependence, which suppresses all feelings except craving for alcohol, which becomes uncontrollable. Patient depressed, irritable, inoperative, upon receiving the alcohol functions are in place, but the loss of control over the amount of alcohol, which leads to excessive drunkenness.

Treatment of Alcoholism   in the second stage must be carried out in the Specialty Hospital, a doctor or psychiatrist, narcologist. Sharp rejection of alcohol causes such symptoms of alcoholism as a somatoneurological exophthalmos , Mydriasis, flushing of the upper body, tremor   fingers, nausea, vomiting, intestinal relief, pain in the heart, liver, and headaches. There are symptoms of mental degradation of the individual, the weakening of the intellect, delusions. Often there are anxiety, night restlessness, seizures, which are the precursors of acute psychosis - delirium tremens, popularly known as "Delirium tremens" .

Complications of alcoholism of the second degree of the liver presented alcoholic hepatitis Often chronic. The disease is more common in persistent form than progressive. As complications in the first degree, hepatitis few clinical symptoms. You can diagnose a complication of gastrointestinal pathology, there is heaviness in the epigastric region of the stomach, right upper quadrant, there is a slight nausea, flatulence. On palpation of the liver seal enlarged and slightly painful.

Alcoholic gastritis at the second stage of alcoholism may have symptoms masquerading as withdrawal symptoms, painful difference is repeated vomiting in the morning, often mixed with blood. On palpation there is pain in the epigastric region.

After long drinking bouts develop acute alcoholic myopathy, there is a weakness, swelling in the muscles of the hips and shoulders. Alcoholism often causes heart disease is not ischemic.

The third stage.   Alcoholism third step differs significantly from the previous two, the duration of this step 5-10 years. This is the final stage of the disease and as practice shows, most of it ends lethally. Reduced tolerance to alcohol intoxication occurs after small doses of alcohol. Binges end physical and psychological exhaustion.

Ranged drunkenness may be replaced by long-term abstinence or preserved systematic daily alcoholism. No activating effect of alcohol intoxication end amnesia. Psychic dependence has no pronounced symptoms as the third stage of alcoholism is undergoing profound mental changes. Physical dependence on its part appears quite defining lifestyle. A person becomes rude, selfish.

In a state of intoxication manifested emotional instability, which is the symptoms of alcoholism, cheerfulness, irritability, anger is unpredictable change each other.

The degradation of the individual, reduced intellectual capacity, inefficiency, leads to the fact that an alcoholic with no means on spirits, uses surrogates to sell things, stealing. The use of such surrogates as a denatured alcohol, cologne, varnish and others. Lead to serious complications.

Complications of the third stage of alcoholism often presented alcoholic cirrhosis. There are two forms of alcoholic cirrhosis - compensated   and decompensated   shape. The first form of the disease characterized by persistent anorexia, flatulence, fatigue, reduced-apathetic mood. There is a thinning of the skin, they have white spots and spider veins. The liver is enlarged, dense, it has a sharp edge.

Outside the patient varies, there is a sharp weight loss, hair loss.
Decompensated form of cirrhosis of the liver in three different types of clinical symptoms. These include portal hypertension, which causes hemorrhoid and esophageal bleeding, ascites - the accumulation of fluid in the abdominal cavity. Frequently observed jaundice, at which the liver is significantly enhanced in cases of severe hepatic failure occurs, with the development of coma. The patient found an increased content Melanin That gives the skin a jaundiced or earthy hue.

Diagnosis of Alcoholism

The diagnosis of alcoholism may be suspected in appearance and behavior. The patients look older than his years, over the years, the face becomes congested, lost skin turgor. A person becomes a special kind of willful debauchery, because relaxation circular muscle of the mouth. In many cases, there is immorality, negligence in clothes.

Diagnosis of alcoholism is in most cases quite accurate, even if the analysis is not the patient, and his entourage. Family members of alcoholics exhibit a number of psychosomatic disorders, neuroticism or psihotizatsiya teetotal husband, pathology in children. The most common diseases in children whose parents abuse alcohol regularly, it is a small congenital cerebral insufficiency. Often these children have excessive mobility, they are not focused, have a craving for destruction and aggressive behavior. In addition to congenital abnormalities in the child's development affects and distressing family situation. The children found the logo-neurosis, enuresis , Night terrors, behavioral disorders. Children of depressed, prone to suicide attempts, they often have difficulties with learning and socializing with peers.

In many cases, pregnant women who abuse alcohol, there fetal alcohol birth. Fetal Alcohol Syndrome is characterized by gross morphological disorders. The most common abnormality of the fetus is the irregular shape of the head, the body proportions, spherical deep-set eyes, underdevelopment of the jaw bones, short tubular bones.

Treatment of Alcoholism

We already briefly described the treatment of alcoholism according to its stages. In most cases, the treatment can occur after relapse. This is due to the fact that treatment is often aimed at eliminating only the most severe manifestations of alcoholism. Without properly conducted psychotherapy, lack of support from loved ones, alcoholism recurs. But as practice shows, this therapy is an important component of treatment.

The first phase of the treatment of alcoholism is to eliminate the acute and subacute states of intoxication caused by the organism .  First held interrupt binge abstinence and elimination disorders .  In the later stages of therapy is carried out only under the supervision of medical personnel, as delirichesky syndrome occurs when interrupt binge requires psychotherapy and some sedatives .  Relief of acute alcoholic psychosis is the rapid immersion of the patient to sleep with dehydration and support of the cardiovascular system . In cases of severe alcohol intoxication alcohol treatment is performed only of specialized hospitals or psychiatric wards .  In the early stages about alcohol treatment may be sufficient, but more often in the refusal of alcohol occurs deficiency of neuroendocrine regulation, the disease progresses and leads to complications and organ pathology .

The second stage of treatment is aimed at the establishment of remission. A complete diagnosis and therapy of the patient mental and physical disorders. Therapy in the second stage of treatment can be quite peculiar, its main task is to eliminate somatic disorders, which are key in the formation of pathological craving for alcohol.

For unconventional therapies include methodology Rozhnova Which is emotional stress therapy. Good prognosis in treatment gives a hypnotic effect and its predecessors psychotherapeutic conversation. During hypnosis the patient is instilled an aversion to alcohol, toshnotno-emetic reaction to the taste and smell of alcohol. Often the method of verbal aversive therapy. It consists in setting up the psyche by verbal suggestion, vomiting responsible reaction to the consumption of alcohol, even in an imaginary situation.

The third stage of treatment involves the extension of remission and return of normal life. This stage can be considered the most important in the successful treatment of alcoholism. After the two previous stages, the person reverts to society, to the problems, friends, that in most cases the same alcohol dependence to family conflicts. This has a greater effect on relapse. In order that a man was able to self-diagnose the symptoms of alcoholism and external long-term therapy is required. The positive effect of autologous provide training, they are widely used for group therapy. Training is the normalization of autonomic disorders and emotional stress after the withdrawal of treatment.

Used Behavioral Therapy So-called correction lifestyle. Man learns to live in a sober state, to solve their problems, acquiring self-management skills. It is an important step in the restoration of normal life is to achieve mutual understanding in the family and its problems.

For successful treatment, it is important to get the patient's desire to get rid of alcohol addiction. Forced treatment does not give such results as voluntary. Yet the refusal of treatment requires the district psychiatrist forced direction of the patient to be treated in the LTP. Therapy in general medical network does not give positive results, as the patient has an open access to alcohol, it is visited by drunken friends, etc.

In the case where alcohol abuse began in adulthood requires an individual approach in the selection of therapy. This is due to the fact that somatoneurological alcoholism symptoms appear much earlier occurrence dependence and mental disorders.

Mortality from alcoholism often associated with complications. There decompensation of vital organs caused by prolonged voraciously, abstinence, intercurrent diseases. 20% of elderly patients have symptoms of alcoholism epilepsy A little less common sharp-Wernicke syndrome Gaye . Seizures of both diseases at the influence of alcohol can be deadly. The presence of alcoholic cardiomyopathy worsens prognosis. Continued systematic use of alcohol results in the death rate.

Less than 25% of patients with this complication live longer than three years after diagnosis.
A high percentage of mortality in alcoholic intoxication takes death as a result of suicide. This contributes to the development of chronic gallyuzinoza, alcohol paraphrenia, delusions of jealousy. The patient is not able to control the crazy thoughts and commits acts unusual in a sober state.